Q&A with CIO Jennifer D’Angelo, Part 2: “Healthcare Is In a Good Place.”

When Jennifer D’Angelo was asked to describe her feelings on where healthcare is headed, particularly in the behavioral health space, the world she used was ‘hopeful.’ Having spent 20 years in the industry, she has certainly seen plenty of fits and starts, but believes the piece are being put into place to “make great strides” in care delivery.

One of those very critical pieces was the recent implementation of PreManage ED, a collaborative care management tool that enables providers to view patient information from ED visits across multiple facilities, upon admission. It’s precisely the kind of initiative that can help “wrap our hands” around the opioid crisis, says D’Angelo.

In this interview, she talks about the work her team is doing at Bergen New Bridge Medical Center to improve behavioral healthcare, both within and outside the organization, the role artificial intelligence can play in facilitating data sharing, and why advocacy is so important to her.

Since technology arrived in healthcare, it’s been a struggle to maintain an accurate master person index. We’ve all sat on committees and tried to establish protocols and algorithms to make sure we don’t have duplicate accounts. This is critical, and not just at the state level.

A patient can have 5 or 10 portals to keep track of, depending on where they go. It’s become a passion of mine to change that and create an environment in which patients can go to one location to access all of their medical records.

How do we go beyond looking at and aggregating the data for our own purposes, and focus on getting it to the patient in the most effective manner possible? I believe AI and open APIs will play a key role in how data is shared and distributed both to patients and providers.

As a CIO, I’m really excited about where we are on our technology journey. We’re reaching a place where we can take the data and really operationalize it and use it to collaborate with other providers. It’s not about competing with other organizations; it’s about caring for patients.

Gamble: You mentioned earlier that Bergen New Bridge Medical Center was the first hospital in the state to go live with the New Jersey Health Information Network (NJHIN). Is the goal to be able to share best practices and offer guidance for other organizations that hope to join?

D’Angelo: We’re still in the early stages at this point. But we did sign up for a use case in which we’re working to develop the master patient index for the entire state. We were the first to go live with the ADT use case, and right now we’re doing fact-finding and data-gathering. We’ll be meeting with the New Jersey Innovation Institute, which is spearheading those initiatives.

It’s really exciting work. The MPI use case is incredibly interesting, and just not for us internally. Since technology arrived in healthcare, it’s been a struggle to maintain an accurate master person index. We’ve all sat on committees and tried to establish protocols and algorithms to make sure we don’t have duplicate accounts. This is critical, and not just at the state level. Being able to take that MPI and pull it into our systems as a permanent tracker would be ideal.

Gamble: That is exciting. Can you talk a little bit about the ADT use case?

D’Angelo: Sure. With that use case, we’re working to be able to share ADT information to and from other providers in the NJHIN. We’re in the process of finalizing the data-sharing components. From there, others will be onboarding and rolling it out.

There’s also the notification piece. This piggybacks a little bit on what the HIEs are doing. We’re looking at that information because we don’t want everyone on alert fatigue for all these various events that are being triggered. HIEs are able to do ADT alerts, but to have the HIN do that, we would at some point look to eliminate the HIE alerting system and move to a full single platform alerting system. That would be ideal.

Gamble: That’s a really interesting area. Do you have a particular user group or committee you rely on to get the clinician viewpoint on things like alert fatigue?

D’Angelo: We do have a committee focused on that. And again, we’re very much in the preliminary stages of rolling out these use cases and alerting systems. We want to get them the information they need, as soon as they need it, but from the right source. We’re in the process of vetting that now with our care coordinators and our utilization review folks. We’re also involving social workers, nurses, and physicians — it’s a multi-disciplinary approach.

Gamble: Is that similar to the approaches you’ve used for other initiatives?

D’Angelo: Absolutely. We make sure to have buy-in from all stakeholders, including anyone who is part of the patient care process.

Gamble: Let’s talk about the discharge process. It’s so important for all patients, but especially in the area of behavioral health, where follow-up care is so essential.

D’Angelo: It varies depending on the program. We have different strategies for inpatient and outpatient. We work with community partners to do follow-ups upon discharge to make sure patients are seeking the next level of care and keeping their appointments. Our facility is unique in that we offer the full continuum of care at one location. And so if a patient comes to our ambulatory clinic for treatment or comes in for detox, they can have that at a single site, which is really unique advantage. We’re always looking at ways to optimize the discharge and planning processes and coordinate that within our own facility, and outside of that, how we do follow-ups with our patients.

The initiatives we’re doing — including the use cases — aren’t just for developing a physician network, and they’re not limited to physicians, care managers, and payers. The data will be used for public health reporting and statewide initiatives. We’re hoping to pull all the silos together and roll them up into the Health Information Network.

Gamble: What about patient engagement — can you talk about the strategy there? I would imagine it depends on the type of care being received.

D’Angelo: That’s correct. There isn’t a patient portal associated with the HIN at this point. That’s really for provider and statewide initiatives. We do, however, have a patient portal that’s part of our HIE platform.

As a CIO, this something I’ve been looking at. A lot of specialties have their own portals, and so a patient can have 5 or 10 portals to keep track of, depending on where they go. It’s become a passion of mine to change that and create an environment in which patients can go to one location to access all of their medical records.

It’s very frustrating for the patient. If they want records from a cardiologist to go to their primary care physician, everything is separated unless they’re in a health system and even then, sometimes it isn’t connected.

Gamble: We’ve recently seen a few developers express interest in behavioral care-focused apps. Do you think we’ll start to see more movement in this area?

D’Angelo: I could see it being a real benefit. Personally, I’d love to be able to develop an app, and I think that’s where things are headed — doing open APIs so patients can access their data when, and how, they need it. I know that’s a big initiative with the new commissioner. At the state level, I think it’s great that were gathering all this data. The question becomes, how do we go beyond looking at and aggregating the data for our own purposes, and focus on getting it to the patient in the most effective manner possible? I believe artificial intelligence and open APIs will play a key role in how data is shared and distributed both to patients and providers.

Gamble: You mentioned HIEs; I know New Jersey has more than one. Is the ultimate goal to pull those separate entities into the NJHIN?

D’Angelo: Some of the HIEs have signed up to partner with NJHIN, which is great. Right now, a number of providers are contributing data through HIEs to the HIN, and some are doing it directly. We’re doing both so that we can test out the two scenarios.

Gamble: It seems like with a lot of these initiatives, the focus is on improvement in the long term. But do you think we’ll start to see some immediate benefits, particularly in terms of connecting the dots and presenting providers with as much data as possible at the point of care?

D’Angelo: I do, and I’m incredibly hopeful. I’ve been doing this for a long time, and I believe we’re finally getting to a place where this is actually going to take off and we’re going to make some great strides in the next few years. Healthcare is in a really good place now, especially in the state of New Jersey. We have so much support from the Commissioner’s Office and the Department of Health to push these initiatives through, and so much passion from the people on the frontlines. There’s a lot of people that are involved with this and there’s a lot of dedicated support. We all look forward to working together collectively as a healthcare system in the state — and not as separate facilities — to best care for our patients.

Gamble: Having that support really is a game-changer.

D’Angelo: It really is. As a CIO, I’m really excited about where we are on our technology journey. We’re reaching a place where we can take the data and really operationalize it and use it to collaborate with other providers. It’s not about competing with other organizations; it’s about caring for patients. And the more we can communicate and share information, the better outcomes we’ll be able to deliver. Hopefully that’s what everyone in healthcare is working toward.

Gamble: Absolutely. This has been really enlightening. Thank you so much for taking the time to speak with us about the work your team is doing, and how far the industry has come in this critical area of care.